What Happened
On 6 July 2023, a pilot was conducting a navigational exercise in a Piper PA-28 (PA-28), registered VH-SFA and operated by Schofields Flying Club Limited, from Bankstown Airport with an intermediate stop at Shellharbour Airport, New South Wales. As the aircraft taxied for departure from Shellharbour, a Saab 340 (Saab), operated by Link Airways as flight FC251 from Brisbane, Queensland to Shellharbour, was on approach to land on runway 34. After landing, the Saab was required to backtrack the runway due to a taxiway weight restriction. As the Saab crew lined up with the centreline to commence their backtrack, they observed the PA‑28 rolling on the runway towards them. They attempted to contact the pilot of the PA-28 via radio but were unable to make contact. To avoid a collision, they moved to the western edge of the runway. The pilot of the PA-28 detected the Saab ahead of them, and after initial hesitation, elected to continue the take-off. They tracked to the eastern side of the runway and passed over the left wing of the Saab at a height of approximately 150 ft.
ATSB Findings
The Australian Transport Safety Bureau (ATSB) found that the pilot of the PA-28 assumed that the Saab would be vacating the runway via a taxiway at the end of the runway. They were not aware of the weight restriction on the taxiway and incorrectly assumed the runway would be clear for their departure. The PA-28 pilot also used non-standard radio phraseology, which did not clearly state that they were entering the runway. The Saab crew re-stated their intention to backtrack on the runway; however, this transmission was not heard by the pilot of the PA-28, and they commenced their take-off. The pilot of the PA-28 detected the Saab at a point where a rejected take-off was almost certainly possible, but due to hesitation and perceived handling difficulties, they elected to continue the take-off from an occupied runway.
Additional findings indicated that the pilot of the PA-28 had observed the Saab commence a right turn on the runway from the holding point but did not continue to monitor it, diverting attention to traffic in the circuit. The decision to expedite the take‑off was influenced by self-imposed time pressure due to traffic density. The pilot was aware that they should not have taken off from an occupied runway. Braking performance calculations showed there was most likely enough room to stop in the distance available when the conflict was detected. The pilot had not conducted a rejected take-off during training, but training records indicated the required competencies had been demonstrated 19 months prior. It could not be determined if the training scenario provided an accurate assessment of threat identification and decision-making skills. The pilot was familiar with Shellharbour circuit procedures but had not previously conducted full-stop landings there, meaning taxiway restrictions were not discussed in pre-flight briefing. The pilot was unaware that larger aircraft could only access the apron by backtracking.
Safety Actions
Schofields Flying Club revised their admission procedures for students trained by other organisations and introduced procedures to increase oversight and standardise competency assessments among flight instructors. Link Airways reviewed their policy and guidance for operations into Shellharbour and encouraged crew to refamiliarise themselves with CASA guidance for radio procedures in non-controlled airspace.